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Renal function is impaired in normotensive chronic HCV patients: role of insulin resistance

Angela Sciacqua1, Maria Perticone2, Eliezer J Tassone1

  • 1Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, V.le Europa, 88100, Catanzaro, Italy.

Internal and Emergency Medicine
|November 25, 2015
PubMed

Insights

Chronic hepatitis C virus (HCV) infection significantly reduces kidney function, indicated by decreased estimated glomerular filtration rate (e-GFR). Insulin resistance, measured by HOMA, is the primary driver of this renal dysfunction in HCV patients.

Area of Science:

  • Nephrology
  • Hepatology
  • Endocrinology

Background:

  • Renal dysfunction is a known risk factor for cardiovascular disease.
  • Chronic hepatitis C virus (HCV) infection is associated with metabolic disturbances, including insulin resistance.
  • The impact of HCV-related insulin resistance on renal function requires further investigation.

Purpose of the Study:

  • To compare renal function in patients with chronic HCV infection, metabolic syndrome, and healthy controls.
  • To investigate the role of insulin resistance and hyperinsulinemia in HCV-related renal dysfunction.
  • To identify predictors of reduced estimated glomerular filtration rate (e-GFR) in HCV patients.

Main Methods:

  • A comparative study involving 130 newly diagnosed HCV outpatients, 130 patients with metabolic syndrome, and 130 healthy subjects.
  • Renal function assessed by e-GFR using the CKD-EPI equation.
  • Laboratory parameters including fasting glucose, insulin, lipids, creatinine, and HOMA (homeostatic model assessment) for insulin sensitivity were measured.

Main Results:

  • HCV patients exhibited significantly lower e-GFR compared to both healthy subjects and metabolic syndrome patients (86.6 vs 120.2 and 94.9 mL/min/1.73 m², respectively).
  • HCV patients showed higher triglyceride, creatinine, fasting insulin, and HOMA levels than healthy subjects.
  • Insulin resistance (HOMA) was a significant predictor of reduced e-GFR in both HCV and metabolic syndrome groups, explaining 27.8% and 30.8% of the variation, respectively.

Conclusions:

  • Chronic HCV infection is associated with significant renal dysfunction, characterized by a reduced e-GFR.
  • Insulin resistance is the primary determinant of renal dysfunction in HCV patients.
  • These findings highlight the importance of managing insulin resistance in HCV patients to preserve kidney function.

Keywords:
Cardiovascular riskChronic C hepatitisInsulin resistanceMetabolic syndromeRenal function

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